title: Frequency of occurrence and antimicrobial susceptibility of Gram-negative bacteremia isolates in patients with urinary tract infection: results from United States and European hospitals (2009-2011).
abstract: We evaluated the frequency of occurrence and antimicrobial susceptibility patterns of Gram-negative bacteria isolated from bacteremic patients with UTI from European (EU) and United States (USA) hospitals during a 3-year period (2009-2011). Susceptibility testing was performed by the reference broth microdilution method on 2071 Gram-negative bacilli. The most frequently isolated pathogens were Escherichia coli (63·3/71·3% in USA/EU), Klebsiella spp. (16·7/11·2%) and Proteus mirabilis (6·4/5·0%). Escherichia coli susceptibility rates were generally similar in the USA and EU, with extended-spectrum beta-lactamase (ESBL)-phenotype rates at 8·1% in both regions. Among Klebsiella spp., ESBL rates varied from 11·4/17·1% in 2009 to 16·1/40·4% in 2011 in USA/EU, and susceptibility rates were generally lower in EU compared to the USA. Pseudomonas aeruginosa exhibited lower susceptibility rates to ceftazidime, meropenem and piperacillin/tazobactam in EU (78·4, 78·4 and 76·5%, respectively) compared to USA (91·2, 88·2 and 91·2%, respectively). In summary, very few antimicrobials provided satisfactory coverage (>90%) when tested against Klebsiella spp. and P. aeruginosa isolates in EU.
authors.forename: Helio S
authors.initials: HS
authors.lastname: Sader
authors.forename: Robert K
authors.initials: RK
authors.lastname: Flamm
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Jones
mesh_terms: D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology*; D004352:Drug Resistance, Microbial; D004754:Enterobacter; D004926:Escherichia coli; D005060:Europe / Q000453:epidemiology; D006090:Gram-Negative Bacteria; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007709:Klebsiella; D008826:Microbial Sensitivity Tests; D011513:Proteus mirabilis; D011550:Pseudomonas aeruginosa; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology*
keywords: Antimicrobial resistance,; ESBL,; Escherichia coli,; Klebsiella spp